OBJECTIVES: The value of ranibizumab as compared to standard care (laser photocoagulation in BRVO and observation in CRVO) was assessed within the framework of a cost-utility analysis (CUA) from the Canadian health care and societal perspectives. METHODS: Cost-utility of ranibizumab to the Canadian health care system was analyzed using a Markov model that followed a cohort of 66 or 68 year old patients (with BRVO or CRVO) over a lifetime time horizon. The model included 8 heath states as defined by best corrected visual acuity (BCVA) and 1 absorbing state for death. Year 1 health state transitions were based on data from the BRAVO and CRUISE trials, while year 2 transitions were based on data from the HORIZON extension trial. From year 3 onwards, health state transitions were based on fixed probabilities of maintaining or worsening BCVA. Health state utilities were derived from both the literature and a Canadian utility study in RVO patients. Resource use and costs were collected from clinical trials, published literature, and standard Canadian sources. Costs and outcomes were discounted at 5% as recommended by Canadian guidelines. RESULTS: From the health care perspective, patients receiving ranibizumab for BRVO accrued an additional 0.22 quality-adjusted life years (QALYs) with a total estimated incremental cost of CAD$8,080, resulting in $36,725 per QALY gained. In CRVO, 0.41 QALYs and $11,466 were estimated, resulting in $28,046 per QALY gained. From the societal perspective, considering costs related to productivity losses, the analyses resulted in an incremental cost per QALY gained of $11,266 for BRVO and $2,103 for CRVO. CONCLUSIONS: Compared to standard care (laser photocoagulation in BRVO and observation in CRVO), ranibizumab shows cost-effectiveness within commonly accepted cost per QALY thresholds from both the health care and societal perspectives.